O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica): estudo preliminar com doze pacientes

Abstract

Laryngeal dystonia (spasmodic dysphonia) is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%), with effects lasting for four months in average and without important side effects.

Use of botulinum toxin for movement disorders

“…Onabot-A was injected in the cricothyreoid membrane, directed toward the thyreoarytenoid muscle, with the aid of electromyography needles. Most of the patients who underwent Onabot-A injection had a significant improvement of their symptoms (83%), with effects lasting for 4 months on average and without important side effects 48. Two meta-analyses confirmed the safety and effectiveness of Onabot-A for the treatment of laryngeal dystonia 49,50…”

Persistent developmental stuttering as a cortical-subcortical dysfunction: evidence from muscle activation

“…In SD physical concomitants are common during speech due to the effort made to speak and possibly due to an associated orofacial dystonia 17,18 . In dystonias secondary to subcortical brain injuries, muscle co-contractions frequently occur, i.e.…”

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“….oi com grande satisfação que recebi a carta do Professor Egberto Reis Barbosa, livre docente em Neurologia da .MUSP, tecendo considerações sobre o artigo recentemente publicado em Arquivos de Neuropsiquiatria 1 .…”

“…Tsuji et al em nosso trabalho se deve basicamente ao fato da Revista Brasileira de Otorrinolaringologia não estar indexada no Index Medicus, somente no latino americano (LILACS).Agradeço os comentários construtivos do Professor Egberto R. Barbosa e peço desculpas pela omissão involuntária do artigo em questão.CEREBRAL ANEURISM AND HIVGostaria de esclarecer um ponto importante no trabalho publicado no número 1 do volume 59 de Arquivos de Neuropsiquiatria1 . O referido artigo é o relato de caso de um paciente de 1 mês de vida com diagnóstico de HIVestabelecido por 3 ELISA e 1 Western-Blot +, apesar de apresentar níveis séricos de CD4/ CD8 dentro dos padrões normais e o PCR para HIV negativo.De acordo com o consenso americano de infecção pediátrica pelo HIV 2 , o diagnóstico de HIV só é estabelecido com o PCR ele deverá ser confirmado após um segundo teste virológico, o mais rápido que possível,após o primeiro teste ter sido liberado.…”